Abdominal Aortic Aneurysm (AAA)

Your largest artery, supplying blood from your heart to your body.

Symptoms and Treatment

Aortic aneurysms are dilatations (or swellings) of the aorta, which is the main artery from the heart supplying blood to the body. They most commonly occur in the abdomen although they can occur in the chest. They do not cause symptoms usually until they rupture, which is often fatal. They are diagnosed by performing an abdominal ultrasound or CT scan. If there is an aortic aneurysm, then there is a possibility that other arteries can also have an aneurysm, most commonly involving the leg artery behind the knee.

The risk of rupture is directly related to the maximum diameter, and treatment is advised when the aneurysm reaches 5.5cm, as this is the size where the risk of rupture overtakes the risk of treatment. The natural history of aortic aneurysms is to slowly enlarge (about 3-5mm per year) although they can remain static for years. Once an aneurysm is diagnosed, then 6-monthly or annual scans should be performed to monitor expansion rate. This can be done in our vascular ultrasound lab.

Symptoms: AAAs often grow slowly and very often there are no symptoms. An aneurysm may start small and stay small or expand quickly. Predicting how fast it may grow is difficult. Once diagnosed the patient will be put on a vascular ultrasound surveillance schedule. As an AAA enlarges some patients may notice the following

Surgical Treatment

Treatment: This depends on severity. The decision to treat an un-ruptured AAA depends upon its size, the risk to the patient to have an operation and the actual age of the patient.

AAAs are grouped into 3 sizes:

Small

Medium (3- 5cm in diameter)

Large (larger than 5-5.5cm in diameter)

The small to medium AAAs will be monitored with regular ultrasound scans. We advise lifestyle changes to stop it growing larger. Aneurysms that are too large or growing too quickly should be repaired with surgery.

We offer 2 types of surgical treatment options.

Open surgery: This is the more traditional treatment option. Open surgery is done to place a prosthetic graft over the affected portion of the aortic artery. Most patients stay in hospital for 4-10 days. Recovery at home can take up to 3 months.

Endovascular aneurysm repair (EVAR): This is a more modern technique and much less invasive. Small incisions are made. Guided by X-ray imaging, your surgeon will place a small expandable device (called a stent graft) into the artery. This procedure has surpassed open aortic surgery as the most common technique for AAA repair.

The best surgical treatment option for you will be will be planned out and discussed with either Mr JK. Wicks or Dr Lupe Taumeopeau.